Research Article

Epidemiological Study of Ossification of the Posterior Longitudinal Ligament Amongst Caucasian Population in A United Kingdom Specialist Spinal Unit

Authors: Nirup Chandrashekar, Rishi Agarwal, Shashank Chitgopkar, Birender Balain, Jayesh Trivedi, Sudarshan Munigangaiah.

DOI: 10.33425/3070-3972.1011

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Abstract

Study Design: Retrospective study.

Objective: This study primarily aims to determine the hospital prevalence of ossification of the posterior longitudinal ligament (OPLL) in the Caucasian population, with a secondary focus on the radiological presentation of OPLL in the UK.

Methods: A total of 43,647 CT scans were reviewed from September 1, 2012, to September 1, 2022. Data collected included the prevalence of OPLL, patient demographics (gender, age), radiological features (levels and size of OPLL, dimensions of the spinal canal, type of OPLL classified by Hirabayashi et al.; history of myelopathy, and any surgical interventions performed (anterior or posterior).

Results: OPLL was identified in 50 Caucasian patients (prevalence of 0.1%). Among them, 74% presented with myelopathy. The most prevalent type was Type B (52%), with nearly equal distributions of bridging and non-bridging cases. The C4 to C6 vertebrae were predominantly involved (18%). The mean size of OPLL was 3.8 mm at C4 and C5, with maximum sizes at C2 (4.8 mm), C6 (4.4 mm), and C7 (4.5 mm). The narrowest spinal canal dimension was found at C7 (6.84 mm). A total of 78% of patients underwent spinal surgery. 82% of these surgeries were posterior.

Conclusion: The prevalence of OPLL in the Caucasian population in the UK is 0.1%, significantly lower than that observed in East Asian populations. However, Caucasian individuals with OPLL exhibit more severe symptoms, including myelopathy.

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